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1
Patrick, Rebecca, and Jonathan Kingsley. "Health promotion and sustainability programmes in Australia: barriers and enablers to evaluation." Global Health Promotion 26, no. 2 (August 23, 2017): 82–92. http://dx.doi.org/10.1177/1757975917715038.
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In an era characterised by the adverse impacts of climate change and environmental degradation, health promotion programmes are beginning to actively link human health with environmental sustainability imperatives. This paper draws on a study of health promotion and sustainability programmes in Australia, providing insights to evaluation approaches being used and barriers and enablers to these evaluations. The study was based on a multi-strategy research involving both quantitative and qualitative methods. Health promotion practitioners explained through surveys and semi-structured interviews that they focused on five overarching health and sustainability programme types (healthy and sustainable food, active transport, energy efficiency, contact with nature, and capacity building). Various evaluation methods and indicators (health, social, environmental, economic and demographic) were identified as being valuable for monitoring and evaluating health and sustainability programmes. Findings identified several evaluation enablers such as successful community engagement, knowledge of health and sustainability issues and programme champions, whereas barriers included resource constraints and competing interests. This paper highlights the need for ecological models and evaluation tools to support the design and monitoring of health promotion and sustainability programmes.
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Baum, Frances, and Valerie A. Brown. "HEALTHY CITIES (AUSTRALIA) PROJECT: ISSUES OF EVALUATION FOR THE NEW PUBLIC HEALTH." Community Health Studies 13, no. 2 (February 12, 2010): 140–49. http://dx.doi.org/10.1111/j.1753-6405.1989.tb00190.x.
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Lambert, Robyn, Naomi Burgess, Nadine Hillock, Joy Gailer, Pravin Hissaria, Tracy Merlin, Chris Pearson, Benjamin Reddi, Michael Ward, and Catherine Hill. "South Australian Medicines Evaluation Panel in review: providing evidence-based guidance on the use of high-cost medicines in the South Australian public health system." Australian Health Review 45, no. 2 (2021): 207. http://dx.doi.org/10.1071/ah20018.
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ObjectiveThe South Australian Medicines Evaluation Panel (SAMEP) was established in 2011 to make evidence-based recommendations on the funding of high-cost medicines in South Australian public hospitals via a high-cost medicines formulary. SAMEP represents one component of South Australia’s process for state-based health technology assessment (HTA). The aim of this study was to describe the experience of SAMEP in the context of Australia’s complex governance model for hospital-based care. MethodsA retrospective review was conducted of the SAMEP process and outcomes of medicine evaluations. Decision summaries and meeting minutes were reviewed and reflected upon by the authors to explore the views of the SAMEP membership regarding the function of the committee and state-based HTA more broadly. ResultsSAMEP has reviewed 29 applications, with 14 (48%) listed on the high-cost medicines formulary. Three applications have been the subject of outcome review and confirm expectations of patient benefit. ConclusionRetrospective review of the committee experience suggests that state-based HTA as operationalised by SAMEP is feasible, provides greater equity of access to high-cost medicines in the South Australian public hospital system and allows for access with evidence development. What is known about the topic?State-based hospital funders often need to make decisions on the provision of high-cost medicines for which there is no national guidance or subsidy. Little published information exists about state-based approaches to medicines evaluation and reimbursement within public hospitals in Australia. What does this paper add?The South Australian experience demonstrates a method for states and territories to tackle the challenges of providing evidence-based access to high-cost medicines in Australian public hospitals. What are the implications for practitioners?This paper provides information for other jurisdictions considering state-based approaches to medicines evaluation and contributes to the broader literature about state-based HTA in Australia.
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Hughes, Emma, Chris King, and Sharon Kitt. "Using the Australian and New Zealand Telehealth Committee framework to evaluate telehealth: Identifying conceptual gaps." Journal of Telemedicine and Telecare 8, no. 3_suppl (December 2002): 36–38. http://dx.doi.org/10.1258/13576330260440790.
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summary Telehealth is strongly supported in policy rhetoric as being economically significant to Australia, but evaluation standards have been insufficiently developed to ensure that this is the case. The use of one such evaluation standard, the Australian and New Zealand Telehealth Committee (ANZTC) framework, for telehealth evaluation in Australia makes good sense. However, that framework emphasizes economic and technical considerations at the expense of social contexts. Furthermore, there must be questions about the utility of a framework which, it appears, has been used to evaluate only a single telehealth project in Australia. The combination of the economic rationalism of health-care policy and the technological determinism of a tool model of information and communication technologies (ICTs) can result in evaluations that fail to match the complexities of the intersection of health-care and ICTs. Using the ANZTC framework while at the same time focusing on explaining, rather than just describing, the links between interventions and outcomes seems a reasonable compromise. This involves understanding complex socio-technical networks and relationships, and requires investigators to engage with the gulf between private opinions, public statements and actual behaviour.
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Luu, Xuan, Kate Dundas, and Erica L. James. "Opportunities and Challenges for Undergraduate Public Health Education in Australia and New Zealand." Pedagogy in Health Promotion 5, no. 3 (August 27, 2019): 199–207. http://dx.doi.org/10.1177/2373379919861399.
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The international emergence of undergraduate education in public health has transformed the public health education landscape. While this shift is clearest and most widely evaluated in the United States, efforts in other parts of the world—such as Australasia—have not kept pace. This article aims to redress the evidence gap by identifying and discussing the different approaches through which Australian and New Zealand universities deliver public health education at the undergraduate level. A content analysis was conducted of online handbook information published by 47 universities across Australia and New Zealand, to gauge the various ways in which these universities implement undergraduate public health education. Each offering identified was assigned to one of four predetermined categories. Of the 47 universities, 45 were found to offer some form of undergraduate coursework in public health. Offerings took primarily the form of single subjects. Less commonly implemented were specializations ( n = 20), stand-alone undergraduate degrees ( n = 11), and double degree combinations ( n = 6). This breadth of activity highlights the need for renewed efforts in evaluating undergraduate public health education across the region. Further research is recommended into three areas: (1) emerging best practices in curriculum development and implementation, (2) explorations of public health accreditation in the region, and (3) the outcomes achieved by students and graduates of undergraduate public health degrees across Australia and New Zealand. These efforts will ultimately strengthen the operationalization and contribution of this education in helping shape the future public health workforce in Australasia.
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Chapman, Simon, and Melanie Wakefield. "Tobacco Control Advocacy in Australia: Reflections on 30 Years of Progress." Health Education & Behavior 28, no. 3 (June 2001): 274–89. http://dx.doi.org/10.1177/109019810102800303.
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Australia has one of the world’s most successful records on tobacco control. The role of public health advocacy in securing public and political support for tobacco control legislation and policy and program support is widely acknowledged and enshrined in World Health Organization policy documents yet is seldom the subject of analysis in the public health policy research literature. Australian public health advocates tend to not work in settings where evaluation and systematic planning are valued. However, their day-to-day strategies reveal considerable method and grounding in framing theory. The nature of media advocacy is explored, with differences between the conceptualization of routine “programmatic” public health interventions and the modus operandi of media advocacy highlighted. Two case studies on securing smoke-free indoor air and banning all tobacco advertising are used to illustrate advocacy strategies that have been used in Australia. Finally, the argument that advocacy should emanate from communities and be driven by them is considered.
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Sebastian, Andi, Liz Fulop, Ann Dadich, Anneke Fitzgerald, Louise Kippist, and Anne Smyth. "Health LEADS Australia and implications for medical leadership." Leadership in Health Services 27, no. 4 (October 6, 2014): 355–70. http://dx.doi.org/10.1108/lhs-03-2014-0028.
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Purpose – The purpose of this paper is to call for strong medical co-leadership in transforming the Australian health system. The paper discusses how Health LEADS Australia, the Australian health leadership framework, offers an opportunity to engage medical clinicians and doctors in the leadership of health services. Design/methodology/approach – The paper first discusses the nature of medical leadership and its associated challenges. The paper argues that medical leaders have a key role in the design, implementation and evaluation of healthcare reforms, and in translating these reforms for their colleagues. Second, this paper describes the origins and nature of Health LEADS Australia. Third, this paper discusses the importance of the goal of Health LEADS Australia and suggests the evidence-base underpinning the five foci in shaping medical leadership education and professional development. This paper concludes with suggestions on how Health LEADS Australia might be evaluated. Findings – For the well-being of the Australian health system, doctors need to play an important role in the kind of leadership that makes measurable differences in the retention of clinical professions; improves organisational cultures; enhances the engagement of consumers and their careers; is associated with better patient and public health outcomes; effectively addresses health inequalities; balances cost effectiveness with improved quality and safety; and is sustainable. Originality/value – This is the first article addressing Health LEADS Australia and medical leadership. Australia is actively engaging in a national approach to health leadership. Discussions about the mechanisms and intentions of this are valuable in both national and global health leadership discourses.
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M. Wallace, Euan. "Prenatal Screening Strategies for Down Syndrome: Many Options but Few Answers." Australian Journal of Primary Health 4, no. 3 (1998): 229. http://dx.doi.org/10.1071/py98053.
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Down syndrome is the single most common cause of severe mental handicap in Australia. Prenatal screening for Down syndrome is therefore an important component of modern antenatal care. However, while effective second trimester serum screening for Down syndrome has been available in Australia for almost a decade it appears that the majority of Australian women, particularly those outside South Australia and New South Wales, are still not offered it. Newer methods of screening have been recently described and are already being offered in routine clinical practice. These methods, including nuchal translucency, will afford results earlier in pregnancy than second trimester serum screening and so are attractive to women. However, available evidence suggests that nuchal translucency may not perform as well as second trimester serum screening and further evaluation of the newer screening strategies in an Australian population is urgently required. Alteration of practice prior to such an evaluation is simply not warranted at this time.
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Broadley, Karen, and Chris Goddard. "A Public Health Approach to Child Protection: Why Data Matter." Children Australia 40, no. 1 (November 3, 2014): 69–77. http://dx.doi.org/10.1017/cha.2014.37.
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In Australia, many researchers and policy makers believe that statutory child protection systems are overburdened and ineffective. The way forward, they suggest, is a public health model of child protection. A public health approach comprises four steps: (1) collecting surveillance data; (2) establishing causes and correlations; (3) developing and evaluating interventions; and (4) disseminating information about the effectiveness of intervention activities to the public health community. However, in Australia there are no reliable surveillance data. There is no information about ‘person’. Information is not collected about the characteristics of children (e.g., ethnicity) and parents (e.g., mental illness) reported to child protection services. Data are not comparable across place. This is because the states and territories have their own child protection legislation, definitions and data recording methods. Data are not comparable over time. This is because many jurisdictions have introduced new data recording systems over recent years. This paper concludes that it is essential to develop an effective child protection surveillance data system. This will ensure that services are located in areas and targeted towards populations in greatest need. It will enable large-scale evaluation of the effectiveness of prevention and intervention activities.
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Kurti, Linda, Susan Rudland, Rebecca Wilkinson, Dawn DeWitt, and Catherine Zhang. "Physician's assistants: a workforce solution for Australia?" Australian Journal of Primary Health 17, no. 1 (2011): 23. http://dx.doi.org/10.1071/py10055.
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Significant medical workforce shortages, particularly in rural and remote locations, have prompted a range of responses in Australia at both state and Commonwealth levels. One such response was a pilot project to test the suitability of the Physician Assistant (PA) role in the Australian context. Five US-trained and accredited PAs were employed by Queensland Health and deployed in urban, rural and remote settings across Queensland. A concurrent mixed-method evaluation was conducted by Urbis, an independent research firm. The evaluation found that the PAs provided quality, safe clinical care under the supervision of local medical officers. The majority of nurses and doctors who worked with the PAs believed that the PAs made a positive contribution to the health care team by increasing capacity to meet patient needs; reducing on-call requirements for doctors; liaising with other clinical team members; streamlining procedures for efficient patient throughput; and providing continuity during periods of doctor changeover. The Pilot demonstrated that a delegated PA role can provide safe, quality health care by augmenting an established healthcare team. The PA role has the potential to benefit the community by increasing the capacity of the health care system, and to improve recruitment and retention by providing an additional professional pathway. The small size of the Pilot limits the ability to generalise regarding the future efficacy of the PA role in Australia. Further research is required to test training and deployment of PAs in a wider range of Australian clinical settings, including general practice and rural health clinics.
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Forssman, Bradley, Leena Gupta, and Graham Burgess. "A case study of the evaluation of a public health intervention." Australian Health Review 30, no. 4 (2006): 458. http://dx.doi.org/10.1071/ah060458.
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Large public health interventions to control infectious disease outbreaks are common, but rigorous evaluation to improve the quality and effectiveness of these is rarely undertaken. Following a large community-based clinic to prevent a hepatitis A outbreak, a multifaceted and multidisciplinary evaluation was conducted involving consumers, health professionals and industry partners. The results of this evaluation were used to produce practical operational guidelines for the planning and conduct of future interventions. These guidelines have been distributed to all public health units in New South Wales and may be included in the next edition of the NSW Health notifiable diseases manual. The evaluation approach can be applied to all public health interventions across NSW and Australia to assist in the development of operational guidelines, in order to increase the quality of public health action in outbreak prevention.
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Sudeshika, Thilini, Mark Naunton, Gregory M. Peterson, Louise S. Deeks, Jackson Thomas, and Sam Kosari. "Evaluation of General Practice Pharmacists: Study Protocol to Assess Interprofessional Collaboration and Team Effectiveness." International Journal of Environmental Research and Public Health 18, no. 3 (January 22, 2021): 966. http://dx.doi.org/10.3390/ijerph18030966.
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The inclusion of pharmacists into general practices has expanded in Australia. However, there is a paucity of research examining interprofessional collaboration and team effectiveness after including a pharmacist into the general practice team in primary or community care. This is a protocol for a cross-national comparative mixed-methods study to (i) investigate interprofessional collaboration and team effectiveness within the general practice team after employing pharmacists in general practices in the Australian Capital Territory (ACT) and (ii) to compare interprofessional collaboration and team effectiveness of pharmacists in general practice across Australia with international sites. The first objective will be addressed through a multiphase sequential explanatory mixed-method design, using surveys and semi-structured interviews. The study will recruit general practice pharmacists, general practitioners, and other health professionals from eight general practices in the ACT. Quantitative and qualitative results will be merged during interpretation to provide complementary perspectives of interprofessional collaboration. Secondly, a quantitative descriptive design will compare findings on interprofessional collaboration (professional interactions, relationship initiation, exchange characteristics, and commitment to collaboration) and team effectiveness of general practice pharmacists in Australia with international sites from Canada and the United Kingdom. The results of the study will be used to provide recommendations on how to best implement the role of general practice pharmacists across Australia.
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Baum, Frances, Barbara Santich, Barry Craig, and Charlie Murray. "Evaluation of a national health promotion program in South Australia." Australian and New Zealand Journal of Public Health 20, no. 1 (February 1996): 41–49. http://dx.doi.org/10.1111/j.1467-842x.1996.tb01334.x.
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J. Donovan, Robert, Geoffrey Jalleh, Johanna Clarkson, and Billie Giles-Corti. "Evidence for the effectiveness of sponsorship as a health promotion tool." Australian Journal of Primary Health 5, no. 4 (1999): 81. http://dx.doi.org/10.1071/py99054.
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Health sponsorships are undertaken to achieve both structural and individual objectives. Structural objectives refer to the sponsored organisation being required to undertake activities such as the imposition of smoke free areas, or the provision of low alcohol beverages and healthy food choices at the sponsored event. Individual objectives refer to creating or reinforcing people's awareness of a health issue or message, and their beliefs, attitudes and behaviours with respect to the issue or message. This paper focuses on sponsorship's capacity to achieve individual level objectives, describing several studies undertaken by the Health Promotion Evaluation Unit (HPEU) at the University of Western Australia to evaluate the health promotion sponsorship activities of Healthway, the Western Australian Health Promotion Foundation. Given the results of evaluations of Healthway's (and other organisations') sponsorship activities, using a variety of methodologies and across a broad range of events and health issues, it is concluded that health sponsorships can be effective at increasing people's salience of a health issue, and can result in attitudinal and behavioural change.
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BAUM, FRANCES, and RICHARD COOKE. "Healthy Cities Australia: the evaluation of the pilot project in Noarlunga, South Australia." Health Promotion International 7, no. 3 (1992): 181–93. http://dx.doi.org/10.1093/heapro/7.3.181.
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Richardson, Jeffrey. "Medical Technology and its Diffusion in Australia." International Journal of Technology Assessment in Health Care 4, no. 3 (July 1988): 407–31. http://dx.doi.org/10.1017/s0266462300000362.
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AbstractThe author examines the Australian health care system by surveying the financing techniques, physical organization, and government activity. He explains the impact of the public and private sectors and comments on the effectiveness of current evaluation procedures. While the author believes that the system is relatively healthy and cost effective, he recognizes a need for more comprehensive and scientific oversight. Using regression analysis and focusing on the installation of medical technology in hospitals, the author attempts to determine the specific factors that influence technology diffusion. He concludes by stressing that further studies analyzing the actual use of specific technologies are vital.
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Haines, Sarah, and Pallavi Prathivadi. "Evaluation of Australian prescription drug monitoring programs need a holistic approach." Australian Journal of Primary Health 27, no. 5 (2021): 354. http://dx.doi.org/10.1071/py20296.
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Prescription opioid-related mortality is increasing in Australia. Real-time Prescription Drug Monitoring Programs (PDMPs) have recently been implemented as a strategy to reduce opioid-related harm. PDMPs enable prescribers and dispensers to view patients’ prescription history before writing or dispensing a high-risk medication. This article considers the complexity of accurately evaluating PDMP effectiveness. To ensure sustainable implementation of these systems in Australia, a wide range of outcomes need to be measured. These include any unintended consequences and impacts on comprehensive patient care. Furthermore, intervention evaluation may be disrupted by concurrent interventions, limited methodologies and the shortcomings of the current approach.
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Price, Pam, and Katherine Leane. "The impact of the impact evaluation: Evaluation of the HIV/AIDS Women's Project 1998." Australian Journal of Primary Health 5, no. 3 (1999): 65. http://dx.doi.org/10.1071/py99035.
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The HIV/AIDS Women's Project (Women's Health Statewide) was established under the auspices of Women's Health Statewide and is supported by a reference group which meets monthly to oversee the work of the Project. The role of the Project is to enhance the health and wellbeing of HIV-positive women and their families in South Australia. In 1998 a consultant was employed to review the role and effectivness of this Project in the HIV/AIDS sector. The evaluation soon evolved beyond its review and evaluation roles, identifying the complex work of the Project and broadening the understanding of women's perspectives in the context of the HIV/AIDS epidemic in South Australia. This paper explores the evaluation process and comments on the effects that participation in the review process has had on both HIV-positive women who participated in the evaluation and on the future work of the Project.
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Miller, Wayne, and June Lennie. "Empowerment Evaluation: A Practical Method for Evaluating a National School Breakfast Program." Evaluation Journal of Australasia 5, no. 2 (September 2005): 18–26. http://dx.doi.org/10.1177/1035719x0500500204.
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Over the past decade, empowerment evaluation has demonstrated its worth as a practical and valuable alternative to traditional program evaluation methodologies. Following a brief overview of the development of empowerment evaluation, we outline its 10 underlying principles and the three key steps involved in conducting an empowerment evaluation. A preliminary case study on our use of this methodology to evaluate the Good Start Breakfast Club program is presented. The Australian Red Cross operates this program in nearly 100 primary schools around Australia with sponsorship and support from the Sanitarium Health Food Company and other organisations. This case study highlights the potential effectiveness of empowerment evaluation in improving and assessing the impacts of other public health and community-based programs in Australia and some of the lessons we have learned so far from using this methodology. We identify strengths and limitations of empowerment evaluation and argue that a more critical approach is required to avoid the idealism that tends to underpin this approach. We suggest that greater attention needs to be paid to the communicative and relational dimensions of empowerment evaluation in order to increase its effectiveness.
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Tannous, Kathy W., Ajesh George, Moin Uddin Ahmed, Anthony Blinkhorn, Hannah G. Dahlen, John Skinner, Shilpi Ajwani, et al. "Economic evaluation of the Midwifery Initiated Oral Health-Dental Service programme in Australia." BMJ Open 11, no. 8 (August 2021): e047072. http://dx.doi.org/10.1136/bmjopen-2020-047072.
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ObjectivesTo critically evaluate the cost-effectiveness of the Midwifery Initiated Oral Health-Dental Service (MIOH-DS) designed to improve oral health of pregnant Australian women. Previous efficacy and process evaluations of MIOH-DS showed positive outcomes and improvements across various measures.Design and settingThe evaluation used a cost-utility model based on the initial study design of the MIOH-DS trial in Sydney, Australia from the perspective of public healthcare provider for a duration of 3 months to 4 years.ParticipantsData were sourced from pregnant women (n=638), midwives (n=17) and dentists (n=3) involved in the MIOH trial and long-term follow-up.Cost measuresData included in analysis were the cost of the time required by midwives and dentists to deliver the intervention and the cost of dental treatment provided. Costs were measured using data on utilisation and unit price of intervention components and obtained from a micro-costing approach.Outcome measuresUtility was measured as the number of Disability Adjusted Life Years (DALYs) from health-benefit components of the intervention. Three cost-effectiveness analyses were undertaken using different comparators, thresholds and time scenarios.ResultsCompared with current practice, midwives only intervention meets the Australian threshold (A$50 000) of being cost-effective. The midwives and accessible/affordable dentists joint intervention was only ‘cost-effective’ in 6 months or beyond scenarios. When the midwife only intervention is the comparator, the midwife/dentist programme was ‘cost-effective’ in all scenarios except at 3 months scenario.ConclusionsThe midwives’ only intervention providing oral health education, assessment and referral to existing dental services was cost-effective, and represents a low cost intervention. Midwives’ and dentists’ combined interventions were cost-effective when the benefits were considered over longer periods. The findings highlight short and long term economic benefits of the programme and support the need for policymakers to consider adding an oral health component into antenatal care Australia wide.Trial registration numberACTRN12612001271897; Post-results.
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Shih, Sophy Ting-Fang, Rob Carter, Craig Sinclair, Cathrine Mihalopoulos, and Theo Vos. "Economic evaluation of skin cancer prevention in Australia." Preventive Medicine 49, no. 5 (November 2009): 449–53. http://dx.doi.org/10.1016/j.ypmed.2009.09.008.
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Walker, Rae, and Hal Swerissen. "Editorial: Recording Excellence in Primary Care Practice." Australian Journal of Primary Health 9, no. 1 (2003): 7. http://dx.doi.org/10.1071/py03001.
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In this issue of the Australian Journal of Primary Health we publish papers that reflect the diverse approaches to knowledge characteristic of primary health care. There are articles on policy and management at the system level (for example, Primary health care research and evaluation development strategy in the Northern Territory), critical reviews of programs and community activities (for example, Motor racing in Australia: Health damaging or health promoting), and the community experiences of health and health services (for example, Communication and control in the co-construction of depression ...). The range of research valued in primary care is reflected in these articles.
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Shah, Smita, Brett G. Toelle, Susan M. Sawyer, Jessica K. Roydhouse, Peter Edwards, Tim Usherwood, and Christine R. Jenkins. "Feasibility study of a communication and education asthma intervention for general practitioners in Australia." Australian Journal of Primary Health 16, no. 1 (2010): 75. http://dx.doi.org/10.1071/py09056.
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The Physician Asthma Care Education (PACE) program significantly improved asthma prescribing and communication behaviours of primary care paediatricians in the USA. We tested the feasibility and acceptability of a modified PACE program with Australian general practitioners (GP) and measured its impact on self-reported consulting behaviours in a pilot study. Recruitment took place through a local GP division. Twenty-five GP completed two PACE Australia workshops, which incorporated paediatric asthma management consistent with Australian asthma guidelines and focussed on effective communication strategies. Program feasibility, usefulness and perceived benefit were measured by questionnaires before the workshop and 1 month later, and an evaluation questionnaire after each workshop. GP were universally enthusiastic and supportive of the workshops. The most useful elements they reported were communication skills, case studies, device demonstrations and the toolkit provided. GP self reports of the perceived helpfulness of the key communication strategies and their confidence in their application and reported frequency of use increased significantly after the workshops. The PACE program shows promise in improving the way in which Australian GP manage asthma consultations, particularly with regard to doctor–patient communication. The impact of the modified PACE Australia program on the processes and outcomes of GP care of children with asthma is now being measured in a randomised controlled trial.
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Begley, Andrea, Danielle Gallegos, and Helen Vidgen. "Effectiveness of Australian cooking skill interventions." British Food Journal 119, no. 5 (May 2, 2017): 973–91. http://dx.doi.org/10.1108/bfj-10-2016-0451.
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Purpose The purpose of this paper is to assess the effectiveness of cooking skill interventions (CSIs) targeting adults to improve dietary intakes in public health nutrition settings. Design/methodology/approach A scoping review of the literature was used to identify and assess the quality and effectiveness of Australian single-strategy CSIs and multi-strategy programmes that included cooking for independent healthy people older than 16 years from 1992 to 2015. Findings There were only 15 interventions (n=15) identified for review and included CSIs as single strategies (n=8) or as part of multi-strategy programmes (n=7) over 23 years. The majority of the interventions were rated as weak in quality (66 per cent) due to their study design, lack of control groups, lack of validated evaluation measures and small sample sizes. Just over half (53 per cent) of the CSIs reviewed described some measurement related to improved dietary behaviours. Research limitations/implications There is inconclusive evidence that CSIs are effective in changing dietary behaviours in Australia. However, they are valued by policymakers and practitioners and used in public health nutrition programmes, particularly for indigenous groups. Originality/value This is the first time that CSIs have been reviewed in an Australian context and they provide evidence of the critical need to improve the quality CSIs to positively influence dietary behaviour change in Australia.
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Spinks, Jean M., and Jeff R. J. Richardson. "Paying the right price for pharmaceuticals: a case study of why the comparator matters." Australian Health Review 35, no. 3 (2011): 267. http://dx.doi.org/10.1071/ah10930.
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This article considers the pricing policy for pharmaceuticals in Australia, which is widely seen as having achieved low drug prices. However, compared to New Zealand, the evidence implies that Australia might have improved its performance significantly if it had proactively sought market best pricing. The Australian record suggests that the information sought by authorities may not be sufficient for optimal pricing and that the economic evaluation of pharmaceuticals may be neither necessary nor sufficient for achieving this goal. What is known about the topic? Pharmaceutical expenditures vary significantly across countries. Few surveys exist to determine the role of price but these suggest that Australian prices are relatively low compared with most OECD countries. What does this paper add? An analysis of public data implies that Australia pays significantly higher prices than NZ for its pharmaceuticals. This is attributable to NZ’s more effective use of competition, especially in the market for generics. Australian policy effectively limits competition by the provision of price information to competing companies. Recent agreements are similarly consistent with de facto regulatory capture. What are the implications for practitioners? There should be a review of pharmaceutical pricing policies with the criterion for success being the ‘lowest’, not ‘comparable’ world prices. Comparators should include prices paid for quality drugs in all, not selected countries, where data are available.
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Lacy, Kathleen E., Melanie S. Nichols, Andrea M. de Silva, Steven E. Allender, Boyd A. Swinburn, Eva R. Leslie, Laura V. Jones, and Peter J. Kremer. "Critical design features for establishing a childhood obesity monitoring program in Australia." Australian Journal of Primary Health 21, no. 4 (2015): 369. http://dx.doi.org/10.1071/py15052.
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Efforts to combat childhood obesity in Australia are hampered by the lack of quality epidemiological data to routinely monitor the prevalence and distribution of the condition. This paper summarises the literature on issues relevant to childhood obesity monitoring and makes recommendations for implementing a school-based childhood obesity monitoring program in Australia. The primary purpose of such a program would be to collect population-level health data to inform both policy and the development and evaluation of community-based obesity prevention interventions. Recommendations are made for the types of data to be collected, data collection procedures and program management and evaluation. Data from an obesity monitoring program are crucial for directing and informing policies, practices and services, identifying subgroups at greatest risk of obesity and evaluating progress towards meeting obesity-related targets. Such data would also increase the community awareness necessary to foster change.
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Donovan, Robert J., Vibeke J. Koushede, Catherine F. Drane, Carsten Hinrichsen, Julia Anwar-McHenry, Line Nielsen, Amberlee Nicholas, Charlotte Meilstrup, and Ziggi Ivan Santini. "Twenty-One Reasons for Implementing the Act-Belong-Commit—‘ABCs of Mental Health’ Campaign." International Journal of Environmental Research and Public Health 18, no. 21 (October 21, 2021): 11095. http://dx.doi.org/10.3390/ijerph182111095.
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While there has been increased attention worldwide on mental health promotion over the past two decades, what is lacking in many countries around the globe is practical knowledge of what constitutes a population-wide mental health promotion campaign, and how such a campaign can be implemented. This paper provides such knowledge based on the development, implementation and evaluation of the Act-Belong-Commit campaign, the world’s first comprehensive population-wide public mental health promotion campaign which was launched in 2008 in Western Australia. Given the learnings from the full-scale implementation and evaluation of the campaign in Western Australia and its expansion nationally and internationally, along with the continuing and expanding evidence base for the campaign constructs, we crystallise 21 reasons why jurisdictions who wish to achieve the goals of the WHO and adopt the recommendations of the European framework on mental health and wellbeing should consider adopting or adapting Act-Belong-Commit when considering implementing a public mental health promotion campaign.
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Lung, Tom W., Janani Muhunthan, Tracey‐Lea Laba, Alan Shiell, Andrew Milat, and Stephen Jan. "Making guidelines for economic evaluations relevant to public health in Australia." Australian and New Zealand Journal of Public Health 41, no. 2 (November 20, 2016): 115–17. http://dx.doi.org/10.1111/1753-6405.12601.
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Mann, Jennifer, Sue Devine, and Robyn McDermott. "Integrated care for community dwelling older Australians." Journal of Integrated Care 27, no. 2 (April 15, 2019): 173–87. http://dx.doi.org/10.1108/jica-10-2018-0063.
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PurposeIntegrated care is gaining popularity in Australian public policy as an acceptable means to address the needs of the unwell aged. The purpose of this paper is to investigate contemporary models of integrated care for community dwelling older persons in Australia and discuss how public policy has been interpreted at the service delivery level to improve the quality of care for the older person.Design/methodology/approachA scoping review was conducted for peer-reviewed and grey literature on integrated care for the older person in Australia. Publications from 2007 to present that described community-based enablement models were included.FindingsCare co-ordination is popular in assisting the older person to bridge the gap between existing, disparate health and social care services. The role of primary care is respected but communication with the general practitioner and introduction of new roles into an existing system is challenging. Older persons value the role of the care co-ordinator and while robust model evaluation is rare, there is evidence of integrated care reducing emergency department presentations and stabilising quality of life of participants. Technology is an underutilised facilitator of integration in Australia. Innovative funding solutions and a long-term commitment to health system redesign is required for integrated care to extend beyond care co-ordination.Originality/valueThis scoping review summarises the contemporary evidence base for integrated care for the community dwelling older person in Australia and proposes the barriers and enablers for consideration of implementation of any such model within this health system.
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Crowe, B. L. "A review of the experience with teleradiology in Australia." Journal of Telemedicine and Telecare 7, no. 2_suppl (December 2001): 53–54. http://dx.doi.org/10.1258/1357633011937128.
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Because of the geographical dispersion of the Australian population (25–30% of the total population of 20 million live outside metropolitan areas), there has been considerable interest in the use of teleradiology. In general, the provision of teleradiology by private radiology practices has been successful. However, as regards the provision of publicly funded, statewide teleradiology services, progress has been slower than expected, following enthusiastic support for the technology in the early 1990s. While there have been some notable successes in the implementation of publicly funded teleradiology services, given the delays that have been experienced in Australia, there is a case for a closer connection between the conduct of teleradiology evaluation studies and the incorporation of the results into health policy. This link would ensure that the benefits of technology are made available to the public in as short a time as possible.
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Okonjo, Benedict, Parul Kaithwas, Jing Miao, Mark Mackay, and Vanessa North. "Writing for the Wider Public - Readability of Publicly Available Board Reports." Asia Pacific Journal of Health Management 16, no. 4 (December 13, 2021): 45–53. http://dx.doi.org/10.24083/apjhm.v16i4.797.
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Objective: This work aims to evaluate the readability of publicly available board reports from the Local Health Networks (LHNs) in South Australia and the National Health Service (NHS) Trusts in England. Method: Publicly available board reports from the LHNs in South Australia and NHS Trusts in England were identified, screened, and evaluated from January 2020 to August 2020. Results: The average Flesch Reading Ease score for all LHNs reviewed ranged from 34 ± 10.2 to 57 ± 0.0 (Difficult to Fairly Difficult). In comparison, the average Flesch Reading Ease score for all the NHS Foundation Trusts ranged from 46 ± 1.7 to 60 ± 3.0 (Difficult to Standard). The average Reading Ease score for metropolitan and non-metropolitan LHNs was 43 ± 8.1 and 41 ± 6.0 (Difficult to read). In contrast, the average Reading Ease score for metropolitan and non-metropolitan NHS Trust was Fairly Difficult with 53 ± 4.2 and 50 ± 3.5 respectively. Conclusion: The evaluation results suggest that there is scope for improving the quality of publicly available board reports from the boards reviewed in terms of their readability by the public.
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Hamirudin, Aliza Haslinda, Abhijeet Ghosh, Karen Charlton, Andrew Bonney, and Karen Walton. "Trends in uptake of the 75+ health assessment in Australia: a decade of evaluation." Australian Journal of Primary Health 21, no. 4 (2015): 423. http://dx.doi.org/10.1071/py14074.
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In Australia, older adults aged 75+ years are encouraged to avail themselves of the comprehensive 75+ health assessment (75+ HA) to identify medical conditions and highlight potential risk factors for poor health. However, uptake of this item has been reported to be low. This study aimed to identify the uptake of the 75+ HA within regional areas of New South Wales and compare this against state and national trends over an 11-year period. Data on uptake of the 75+ HA for item numbers 700 and 702, from 1999 until 2010, were obtained from the Medicare Australia portal and Department of Health and Ageing databases. Trends over time were collated and compared at the regional, state and national level. The study found that an increasing number of the 75+ HAs were performed from 1999 to 2009. Overall, the uptake of the 75+ HA is generally low across Australia, at ~20% of the eligible population, but varied across states and even regions within states. The study also revealed that despite low uptake encouraging trends were evident over a decade of 75+ HA implementation. It is argued that strategies in improving the uptake should be targeted for early identification of health risk and overall improved quality of health in older adults.
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Banham, David, John Lynch, and Jon Karnon. "An equity - effectiveness framework linking health programs and healthy life expectancy." Australian Journal of Primary Health 17, no. 4 (2011): 309. http://dx.doi.org/10.1071/py11034.
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South Australia’s Strategic Plan includes a target to improve the population’s healthy life expectancy. A common question among health policy and service planners is: ‘How do health programs and services in the community relate to healthy life expectancy?’ In response, this paper outlines an effectiveness and equity framework (EEF) for evaluating health interventions in applied settings. Using the example of coronary heart disease (CHD) management in general practice in South Australia, the EEF: (1) applies an internally consistent approach to accounting for population healthy life expectancy at state and smaller geographic levels; (2) estimates average population health gains from health programs, and gains across different socioeconomic subgroups within the community; (3) conducts economic evaluation by equating health gains against health system costs in population subgroups; (4) summarises relevant information about candidate intervention programs within a multi-criteria performance matrix for presentation to decision makers; (5) reassesses outcomes (and processes) following the implementation of a program and iteratively adds to the relevant knowledge and evidence base. The EEF offers a practical approach to selecting and evaluating intervention programs. The challenge is to develop system culture and data capture methods clearly focussed on linking health system activities to population health outcomes.
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Baum, Fran. "Community Health Services and Managerialism." Australian Journal of Primary Health 2, no. 4 (1996): 31. http://dx.doi.org/10.1071/py96053.
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In this paper, the impact is described of the introduction of the new public management (NPM) on community health services in Australia. From the late 1980s NPM techniques, modelled largely on private sector practices, have been popular with federal and state governments and have affected the management of community health services. Services have been amalgamated, asked to evaluate their work in inappropriate ways and been pressured to a quasi market form of operation. Three fundamantal differences between a primary health care and NPM approach to management are defined and discussed: whether the focus is on individuals or societies, whether it is on public service or profit, and whether it is on meaningful outcomes or those which appear measurable. The paper concludes with a call for the evaluation of the NPM and a return to a more civic and socially focussed public management.
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Ozanne-Smith, J. "Controlled evaluation of a community based injury prevention program in Australia." Injury Prevention 8, no. 1 (March 1, 2002): 18–22. http://dx.doi.org/10.1136/ip.8.1.18.
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Foster, J’Belle, Diana Mendez, Ben J. Marais, Justin T. Denholm, Dunstan Peniyamina, and Emma S. McBryde. "Critical Consideration of Tuberculosis Management of Papua New Guinea Nationals and Cross-Border Health Issues in the Remote Torres Strait Islands, Australia." Tropical Medicine and Infectious Disease 7, no. 9 (September 19, 2022): 251. http://dx.doi.org/10.3390/tropicalmed7090251.
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The international border between Australia and Papua New Guinea (PNG) serves as a gateway for the delivery of primary and tertiary healthcare for PNG patients presenting to Australian health facilities with presumptive tuberculosis (TB). An audit of all PNG nationals with presumptive TB who presented to clinics in the Torres Strait between 2016 and 2019 was conducted to evaluate outcomes for PNG patients and to consider the consistency and equity of decision-making regarding aeromedical evacuation. We also reviewed the current aeromedical retrieval policy and the outcomes of patients referred back to Daru General Hospital in PNG. During the study period, 213 PNG nationals presented with presumptive TB to primary health centres (PHC) in the Torres Strait. In total, 44 (21%) patients were medically evacuated to Australian hospitals; 26 met the evacuation criteria of whom 3 died, and 18 did not meet the criteria of whom 1 died. A further 22 patients who met the medical evacuation criteria into Australia were referred to Daru General Hospital of whom 2 died and 10 were lost to follow-up. The cross-border movement of people from PNG into Australia is associated with an emergent duty of care. Ongoing monitoring and evaluation of patient outcomes are necessary for transparency and justice.
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Shih, S., R. Carter, S. Heward, and C. Sinclair. "Costs Related to Skin Cancer Prevention in Victoria and Australia." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 9s. http://dx.doi.org/10.1200/jgo.18.10800.
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Background: The aim of this presentation is to provide an update on the economic evaluation of the Australian SunSmart program as well as outline the cost of skin cancer treatment to the Victorian public hospital system. This follows the publication of two recently released published economic evaluations that discusses the potential effects of skin cancer prevention inventions. Aim: 1. To highlight the cost effectiveness of skin cancer prevention in Australia 2. To highlight the costs of skin cancer treatment in the Victorian public hospital system 3. To provide strong evidence to inform governments of the value of skin cancer prevention to reduce the costs of treatment in future years. Methods: Program cost was compared with cost savings to determine the investment return of the program. In a separate study, a prevalence-based cost approach was undertaken in public hospitals in Victoria. Costs were estimated for inpatient admissions, using state service statistics, and outpatient services based on attendance at three hospitals in 2012-13. Cost-effectiveness for prevention was estimated from 'observed vs expected' analysis, together with program expenditure data. Results: With additional $AUD 0.16 ($USD 0.12) per capita investment into skin cancer prevention across Australia from 2011 to 2030, an upgraded SunSmart Program would prevent 45,000 melanoma and 95,000 NMSC cases. Potential savings in future healthcare costs were estimated at $200 million, while productivity gains were significant. A future upgraded SunSmart Program was predicted to be cost-saving from the funder perspective, with an investment return of $3.20 for every additional dollar the Australian governments/funding bodies invested into the program. In relation to the costs to the Victorian public hospital system, total annual costs were $48 million to $56 million. Skin cancer treatment in public hospitals ($9.20∼$10.39 per head/year) was 30-times current public funding in skin cancer prevention ($0.37 per head/year). Conclusion: The study demonstrates the strong economic credentials of the SunSmart Program, with a strong economic rationale for increased investment. Increased funding for skin cancer prevention must be kept high on the public health agenda. This would also have the dual benefit of enabling hospitals to redirect resources to nonpreventable conditions.
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Dalziel, Kim, Leonie Segal, and Rachelle Katz. "Cost-effectiveness of mandatory folate fortification v. other options for the prevention of neural tube defects: results from Australia and New Zealand." Public Health Nutrition 13, no. 4 (September 17, 2009): 566–78. http://dx.doi.org/10.1017/s1368980009991418.
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AbstractObjectiveTo provide input to Australian and New Zealand government decision making regarding an optimal strategy to reduce the rate of neural tube defects (NTD).DesignStandard comparative health economic evaluation techniques were employed for a set of intervention options for promoting folate/folic acid consumption in women capable of or planning a pregnancy. Evidence of effectiveness was informed by the international literature and costs were derived for Australia and New Zealand.ResultsPopulation-wide campaigns to promote supplement use and mandatory fortification were the most effective at reducing NTD, at an estimated 36 and 31 fewer cases per annum respectively for Australia and New Zealand, representing an 8 % reduction in the current annual NTD rate. Population-wide and targeted approaches to increase supplement use were cost-effective, at less than $AU 12 500 per disability-adjusted life year (DALY) averted ($US 9893, £5074), as was extending voluntary fortification. Mandatory fortification was not cost-effective for New Zealand at $AU 138 500 per DALY ($US 109 609, £56 216), with results uncertain for Australia, given widely varying cost estimates. Promoting a folate-rich diet was least cost-effective, with benefits restricted to impact on NTD.ConclusionsSeveral options for reducing NTD appear to fall well within accepted societal cost-effectiveness norms. All estimates are subject to considerable uncertainty, exacerbated by possible interactions between interventions, including impacts on currently effective strategies. The Australian and New Zealand governments have decided to proceed with mandatory fortification; it is hoped they will support a rigorous evaluation which will contribute to the evidence base.
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Isbanner, Sebastian, Julia Carins, and Sharyn Rundle-Thiele. "Healthy Eats—Evaluation of a Social Marketing Program Delivered in Primary School Settings in Queensland." International Journal of Environmental Research and Public Health 19, no. 21 (November 3, 2022): 14415. http://dx.doi.org/10.3390/ijerph192114415.
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One in four school children in Australia are overweight or obese. In response, the Healthy Eats program was developed, piloted, and delivered using a whole-of-school approach underpinned by the socio-ecological model to increase fruit and vegetable consumption among children aged 8–10 years in regional Queensland, Australia. This research presents an outcome evaluation of the Healthy Eats program using pre–post data collected throughout 2021 (cross-sectional for knowledge and longitudinal for behaviour) from 19 schools to assess whether changes occurred in students’ nutritional knowledge (n = 1868 (pre = 933, post = 935)) and fruit and vegetable consumption (n = 1042 (pre = 521, post = 521)). Knowledge data was collected via self-reports two weeks prior and immediately after the Nutrition Module. Behavioural data on daily fruit and vegetable consumption was gathered via student passports (i.e., surveys) one week before and for four consecutive weeks after the Nutrition Module. Chi-Square Difference tests and t-Tests were conducted with a significance level set at p < 0.05. Across all 19 schools, knowledge of the daily recommended serves of fruit and vegetables improved significantly following participation in the program, aligning knowledge closer to the Australian dietary guidelines. Behavioural results for fruit consumption were favourable, with clear improvements reported. Increases in vegetable consumption were demonstrated in two of the eight schools. A discussion on the knowledge–action gap is provided, including recommendations for future iterations of the Healthy Eats program.
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Day, Rebecca Trowman, Richard Norman, and Suzanne Robinson. "Challenges and opportunities for disinvestment in Australia." Journal of Health Organization and Management 30, no. 8 (November 21, 2016): 1301–7. http://dx.doi.org/10.1108/jhom-10-2016-0189.
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Purpose Worldwide, there is significant growth in the cost of (and demand for) healthcare, which often clashes with a requirement to contain expenditure. This duality leads to an increasing need for a systematic approach to disinvestment in health technologies. The purpose of this paper is to consider the challenges and opportunities for disinvestment policy decisions in Australia. It discusses the implementation of the Choosing Wisely campaign and the need for rigorous evaluation of such campaigns in the Australian healthcare system. Design/methodology/approach The authors highlight characteristics of disinvestment: what it is and what it is not and discuss international examples of identifying low value care, including the recent Choosing Wisely initiative. The authors discuss the barriers to implementing initiatives such as Choosing Wisely and the complexities in evaluating their effectiveness. Findings While the primary purpose of the Choosing Wisely campaign is improved decision making through clinical engagement, it is expected that implementation could lead to resource savings alongside improvements in patient safety and service quality. While there is research looking to understand the barriers and facilitators to the implementation of initiatives such as Choosing Wisely, little is known about broader patient impacts, and more attention on the quantification of their effect on both patient outcomes and resource use is needed. Originality/value This work highlights the limited knowledge around implementation of disinvestment strategies and the paucity of research around the impact of strategies such as Choosing Wisely in the Australian public hospital system. This is important as future research in this area will give greater certainty about the benefits and consequences of Choosing Wisely leading to improved opportunities for resource savings and patient safety and quality.
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Ali, Hammad, Holly Seale, Kirsten Ward, and Nicholas Zwar. "A picture speaks a thousand words: evaluation of a pictorial post-vaccination care resource in Australia." Australian Journal of Primary Health 16, no. 3 (2010): 246. http://dx.doi.org/10.1071/py10002.
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Evaluating the ‘Common Reactions to Vaccination’ post-vaccination care resource was seen as an opportunity to contribute to the limited literature base in this important area, learn from the strengths and weaknesses of the resource and gain insight into post-vaccination care practices. Semi-structured in-depth interviews were conducted with 12 general practitioners and 29 practice nurses in New South Wales and Australian Capital Territory, Australia. Structured interview guides were used and data was analysed thematically. A self-administered survey was also distributed to parents or guardians during routine childhood vaccination visits. When compared with previous resources, participants felt the new resource was more appropriate as it had a simple layout; it was colourful, incorporated pictures and had basic and practical information. Information about post-vaccination care and common reactions to vaccination must be provided in written form accompanied by a verbal reinforcement so that patients can revisit the information at a later stage if required. The ‘Common Reactions to Vaccination’ post-vaccination care resource provides comprehensive information in an easy-to-understand pictorial way and was appreciated by both vaccination providers and patients.
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Northcote, Jeremy, and Peter J. Hancock. "Differences in Satifaction Ratigns of Carer-Respite Services between Carer Types: Results of a Western Australian Evaluation." Australian Journal of Primary Health 11, no. 3 (2005): 88. http://dx.doi.org/10.1071/py05047.
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Respite care offers caregivers a temporary relief from the duties of their caring role. This study examines whether caregivers' satisfaction ratings of the agencies that coordinate respite care services vary according to their relationship to the care-receiver. One hundred and seventy-seven clients of Australian Red Cross Carer Respite Centres in Western Australia were surveyed by telephone to determine their satisfaction levels with the information and referral services they received. Those caring for children - although expressing a generally high level of satisfaction - indicated significantly lower levels of satisfaction than other carer groups on two specific criteria: the initial provision of information and the ability of the centre to cater to all their needs. It is recommended that service providers, health practitioners and researchers alike pay close attention to different carer types in the design, implementation and evaluation of respite programs.
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Crooks, Kristy, Kylie Taylor, Charlee Law, Sandra Campbell, and Adrian Miller. "Engage, understand, listen and act: evaluation of Community Panels to privilege First Nations voices in pandemic planning and response in Australia." BMJ Global Health 7, no. 8 (August 2022): e009114. http://dx.doi.org/10.1136/bmjgh-2022-009114.
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IntroductionFirst Nations Peoples of Australia have not been included in the development nor prioritised in pre-2009 pandemic plans despite being a priority population in Australian health policy. Marginalised groups experience amplified barriers and systemic disadvantage in emergencies, however, their voices have not been heard in past pandemic responses. Through effective engagement with disadvantaged and oppressed groups, health authorities can gain a deeper understanding of how to design and implement pandemic control strategies. There have been limited studies with First Nations Peoples that has focused on pandemic planning and response strategies. Deliberative inclusive approaches such as citizens juries have been a way to uncover public perceptions.MethodsQualitative thematic research methods were used to conduct the study. We convened five First Nations Community Panels in three locations in Australia between 2019 and 2020. We used an Indigenist research approach, community-based Participatory Action Research framework and ‘yarning’ to understand whether Community Panels were an acceptable and appropriate way of engaging First Nations Peoples. Forty First Nations participants were purposively recruited through local and cultural networks. Panels heard evidence supporting various pandemic response strategies, and cross-questioned public health experts.ResultsAll 40 participants from the 5 panels verbally indicated strong support of the Community Panels approach as an effective way of engaging First Nations Peoples in making decisions about pandemic planning and response strategies. The main theme of ‘respect’ centred on the overarching principle that First Nations Peoples are important in the context of continuation of culture and ongoing political resistance.ConclusionFirst Nations Community Panels are a way of enabling active participation of First Nations peoples, increasing knowledge and understanding, and a way for government and policymakers to respectfully listen to First Nations opinions and values.
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Jackson, Terri. "Cost estimates for hospital inpatient care in Australia: evaluation of alternative sources." Australian and New Zealand Journal of Public Health 24, no. 3 (June 2000): 234–41. http://dx.doi.org/10.1111/j.1467-842x.2000.tb01562.x.
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Lambert, Stephen, and Christine Selvey. "Is this really an ethical evaluation of HPV vaccination policy in Australia?" Australian and New Zealand Journal of Public Health 36, no. 1 (February 2012): 96. http://dx.doi.org/10.1111/j.1753-6405.2012.00832.x.
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O'Malley, Sue P., and Ernest Jordan. "Horizon scanning of new and emerging medical technology in Australia: Its relevance to Medical Services Advisory Committee health technology assessments and public funding." International Journal of Technology Assessment in Health Care 25, no. 03 (July 2009): 374–82. http://dx.doi.org/10.1017/s0266462309990031.
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Objectives:In 1998, a formal process using full health technology assessments (HTAs) was implemented to determine the suitability for public subsidy of new and emerging medical technologies in the Australian private healthcare sector. This process is overseen by the Medical Services Advisory Committee (MSAC). In 2004, horizon scanning was introduced in Australia with the stated objective of identifying new and emerging medical technologies into the public healthcare sector, with consideration to the publicly subsidized private healthcare sector. How well horizon scanning works in identifying new and emerging technologies suitable for government subsidized funding in the private healthcare sector is examined in this study.Methods:A descriptive evaluation of the impact of horizon scanning as an early alert and awareness system identifying new and emerging technologies before these technologies are submitted to MSAC for a full HTA. All MSAC HTAs commenced after the introduction of horizon scanning in 2004 were cross-checked with the list of Prioritizing Summaries or Horizon Scanning Reports to determine whether a prior Prioritizing Summary or Horizon Scanning Report had been carried out.Results:Of the forty-three technologies that were the subject of a full MSAC HTAs in the time period examined, only eleven had been the subject of either a Prioritizing Summary or Horizon Scanning Report. As a result of a full MSAC HTA, twelve of the technologies that were not the subject of a Prioritizing Summary or Horizon Scanning Report were given positive recommendations for public funding.Conclusions:Horizon scanning was set up to scan the introduction of new and emerging medical technologies into the public healthcare sector, with consideration to the publicly subsidized private healthcare sector. Based on the number of new and emerging technologies that have been the subject of a full MSAC HTA without first being subjected to either a Prioritizing Summary or Horizon Scanning Report, horizon scanning in Australia does not function as an “early alert and awareness system” for funding in the publicly subsidized private healthcare sector in Australia.
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Baum, Fran, Adam Graycar, Toni Delany-Crowe, Evelyne de Leeuw, Carol Bacchi, Jennie Popay, Lionel Orchard, et al. "Understanding Australian policies on public health using social and political science theories: reflections from an Academy of the Social Sciences in Australia Workshop." Health Promotion International 34, no. 4 (April 19, 2018): 833–46. http://dx.doi.org/10.1093/heapro/day014.
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AbstractThere is strong, and growing, evidence documenting health inequities across the world. However, most governments do not prioritize policies to encourage action on the social determinants of health and health equity. Furthermore, despite evidence concerning the benefits of joined-up, intersectoral policy to promote health and health equity, it is rare for such policy approaches to be applied systematically. To examine the usefulness of political and social science theory in understanding the reasons for this disjuncture between evidence and practice, researchers and public servants gathered in Adelaide for an Academy of the Social Sciences in Australia (ASSA) Workshop. This paper draws together the learnings that emerged from the Workshop, including key messages about the usefulness of various theories as well as insights drawn from policy practice. Discussions during the Workshop highlighted that applying multiple theories is particularly helpful in directing attention to, and understanding, the influence of all stages of the policy process; from the construction and framing of policy problems, to the implementation of policy and evaluation of outcomes, including those outcomes that may be unintended. In addition, the Workshop emphasized the value of collaborations among public health researchers, political and social scientists and public servants to open up critical discussion about the intersections between theory, research evidence and practice. Such critique is vital to render visible the processes through which particular sources of knowledge may be privileged over others and to examine how political and bureaucratic environments shape policy proposals and implementation action.
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Sved Williams, Anne, and Jill Poulton. "Supporting Mental Health in the Community: New Systems for General Practice." Australian Journal of Primary Health 12, no. 2 (2006): 105. http://dx.doi.org/10.1071/py06029.
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General practitioners (GPs) manage nearly one-third of Australians seeking help for mental health problems, and frequently express their need for consultant psychiatric support in this work. The introduction of new Medical Benefits Schedule Item Numbers 291 and 293 to provide "one-off" psychiatric assessments on referral from GPs offered the potential for providing this support, and a single point-of-entry scheme was organised to provide ease of access to appointments. The aims were to establish a single point of entry for psychiatrist assessment using Item 291, to evaluate the take-up rates of Item 291 in South Australia (SA) through this service and to evaluate the acceptability to GPs and psychiatrists of a psychiatric primary care consultation-liaison (c-l) model. Results were: 26 psychiatrists joined the project; 64 GPs referred 78 patients for assessment, providing 24% of the Australian take-up rate for Item 291, for 8% of the population; evaluation showed high approval ratings from GPs who particularly appreciated the single contact point; and positive evaluation by psychiatrists of the primary care c-l model. The conclusions were that a single contact point provided ease of access to psychiatrists for GPs; GP and psychiatrist groups evaluated Item 291 very positively; and consumer and carer evaluation are essential for further primary care c-l development.
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Altaf, Nishath, Thathya V. Ariyaratne, Adrian Peacock, Irene Deltetto, Jad El-Hoss, Shannon Thomas, Colman Taylor, and Patrice Mwipatayi. "PP339 A Budget Impact Model Of The EluviaTM Drug-Eluting Stent from The Australian Public Hospital And National Payer Perspective." International Journal of Technology Assessment in Health Care 36, S1 (December 2020): 29. http://dx.doi.org/10.1017/s0266462320001609.
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IntroductionImproving long-term outcomes like target lesions revascularizations (TLRs) is a focus for endovascular interventions aimed at treating symptomatic lower-limb peripheral arterial disease (PAD). EluviaTM, a paclitaxel-eluting drug-eluting stent (DES) was shown to further reduce TLRs when compared with the paclitaxel-coated Zilver® PTX® stent in the IMPERIAL trial, a global, randomized controlled study. This budget-impact evaluation investigated cost-savings from Eluvia-use when compared with Zilver PTX, relying on the 12- to 24-month outcomes from the IMPERIAL trial.MethodsA budget-impact model comparing Eluvia and Zilver PTX was developed from the Australian public healthcare payer, and an individual hospital perspective, with a 5-year time-horizon. Observed trial results were applied to each year's incident population and associated costs, and no extrapolation was conducted. The analysis used publicly available Australian national hospital cost data, population estimates, procedural statistics, epidemiological literature, and data from public hospital audits to verify eligible population for endovascular procedures (EVP) including DES. All costs were captured in Australian dollars (AUD), where AUD 1 = USD 0.69 (June 2020).ResultsAssuming 80-percent EVP eligibility, and a DES-use range of 10–28 percent, the 5-year model estimated potential national savings of AUD 4.3–12.1 million (M) [USD 3–8.3M] to the public healthcare payer, driven by reduced TLRs from Eluvia-use compared with Zilver-PTX. The model projected potential national savings of AUD 33.1–92.6M (USD 22.8–63.9M) to individual hospitals through reduced hospital bed days for adverse events (AE). The model forecasted 14,428–40,399 treated patients; 1,499–4,198 fewer TLRs; and 16,515–46,243 fewer hospital days for AE. At a state level, projected hospital savings were: New South Wales AUD 10.9–30.7M [USD 7.5–21.1M]; Victoria AUD 8.4–23.4M [USD 5.8–16.1M]; Queensland AUD 6.5–18.3M [USD 4.5–12.6M]; Western Australia AUD 3.4–9.5M [USD 2.3–6.5M]; South Australia AUD 2.3–6.4M [USD 1.6–4.4M].ConclusionsTreatment of symptomatic lower-limb PAD with the Eluvia DES could lead to potential savings for the Australian healthcare system, at the national, state, and the local hospital level, based on improved patient outcomes.
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Feyer, Anne-Marie, Caitlin Francis, Ray Quigley, Rebecca Jessop, and John Walsh. "The sharing health care initiative: Issues in design of the evaluation of a national program of demonstration projects for self-management of chronic conditions." Australian Journal of Primary Health 9, no. 3 (2003): 208. http://dx.doi.org/10.1071/py03048.
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This paper aims to consider the key issues in defining and measuring elements for evaluation of the national program of the Sharing Health Care Initiative (SHCI), and to describe the design of the national evaluation framework. Key parts of the chronic disease self-management literature and the evaluation literature were reviewed. The implications of the literature for design of the national evaluation are outlined. Three key issues needed to be addressed in the national evaluation of the SHCI - a program of diverse demonstration projects funded to develop generic self-management approaches. First, a guiding principle of the national evaluation was identification of common project features for analysis against some standard impact and outcome measures, to allow aggregated and comparative analysis. Second, strong emphasis on process evaluation was critical in order to allow analysis of which elements were successful and which were not. Third, the national evaluation was focused more broadly than efficacy at the program participant level; it also covered factors that are likely to contribute to development of self-management programs in the Australian context. The focus of the national evaluation of the SHCI was clearly defined in line with its national role, and reflecting its focus on providing information for future policy options to most effectively develop chronic condition self-management approaches in Australia. Comprehensive evaluation of a range of factors beyond efficacy at the individual client level is needed to assist in understanding the potential effectiveness of population-based implementation of interventions with well-demonstrated efficacy.